Use this form to claim reimbursement for out-of-pocket expenditures related to prior approved travel transactions; these include conference, seminar, and workshop expenses which may or may not involve an overnight stay. (Non-Prior Approval travel transactions, such as itinerant travel between work locations, are not claimed on this form.) Claim forms must be submittedwithin 30 days of the employee’s return date and must include a copy of the prior approval form.
The amounts being claimed must reasonably match the estimated amounts
approved on the Prior Approval form. Reimbursement checks will be
mailed to the employee’s home address.

Please refer to District Board Policy 6213 and Regulation 6213R for more information on district related travel.

Month/Year - Enter the month and year the travel actually occurred. This will determine which year the expenses are charged to.

Conference Information - Enter the name of the conference and where it was held. This will determine the allowable per diem rates.

Travel Dates - Enter the date of your departure and the date you returned.

Registration (5749) – Enter the total registration fee for which you paid out-of-pocket. Original receipts are required.

TravelExpenses
(5849) – Enter the amounts paid out-of-pocket for transportation,
lodging, fares, car rental, and parking separately in the spaces
provided. Original receipts are required. The sum total of these items
should be entered on the TOTAL TRAVEL EXPENSE line.

Other – Enter any other
out-of-pocket travel expenses for which there is not a specific line
item. These may include books or other materials required for the
workshop attended. Original receipts are required. Entertainment
related costs will not be reimbursed.

Mileage (5848) – Enter
the travel date, a general description of the “FROM” (origin) and “TO”
(destination), and the round trip mileage (rounded to nearest 1/10th
of a mile). Mileage to and from the hotel, to and from the airport,
and to and from the event are reimbursable. Personal mileage (e.g. to
and from a restaurant) is not reimbursable. Mileage is reimbursed at
the current IRS rate.

Per Diem Allowance (5847)
– For travel involving an overnight stay, check the breakfast, lunch
and/or dinner boxes for each day while on travel status for meals paid
for out-of-pocket. Meals taken on the employee’s final day of travel
should be checked in the LAST DAY column. Employees will receive 75% of
the per diem allowance on the first and last days of travel. Do NOT
check the boxes for any meals that were provided as part of the
conference registration fees. Where identifiable costs of meals are
included in conference registration fees, the breakfast, lunch and/or
dinner components will be deducted from the employee’s per diem
allowance. Receipts are NOT required. However, a copy of the conference registration form/itinerary showing the schedule of events and meals provided is required for verification purposes.

For local travel assignments not involving an overnight stay, meals shall be reimbursed at the breakfast, lunch and dinner component of the $44 per diem rate.

The incidentals portion of the per
diem allowance is intended to cover customary tips; baggage handling
fees and tips; and hotel/motel services.

Per diem rates are established by the
U.S. General Services Administration and are subject to change. Current
rates can be found online at www.gsa.gov.
Employees will be reimbursed from one of the per diem rates listed
below based on their primary travel destination. The Accounting
Department will verify the applicable rate.

Per Diem Total

$39

$44

$49

$54

$59

$64

Breakfast

$7

$8

$9

$10

$11

$12

Lunch

$11

$12

$13

$15

$16

$18

Dinner

$18

$21

$24

$26

$29

$31

Incidentals

$3

$3

$3

$3

$3

$3

NOTE:
The Accounting Department will verify the applicable per diem rate
based on the employee’s primary travel destination and calculate the
total per diem and total reimbursement owed to the employee.

SUBMISSION OF CLAIM FORM

When completed, employees must sign and date the CERTIFICATION section of the form; attach required receipts, a copy of the prior approval form and the conference registration/itinerary.

The form must then be forwarded to the
employee’s immediate supervisor and the director with budget authority
for the expenditures for their signature(s) in the APPROVAL section of
the form.

The supervisor or director must place
the appropriate budget codes(s) on the form. If more than one budget
code will be used, the AMOUNT OR PERCENT line must be completed for each
budget code so the appropriate amounts are applied to each budget at
the time of processing.

The form and all pertinent
documentation must then be forwarded to the applicable Accounting
Services Specialist in the Business Office at 109.

NOTE:
If a form is received by the Accounting Department without the proper
documentation, the form will be returned unprocessed to the employee
with a note asking for the missing documentation.

The Puyallup School District, in partnership with our diverse communities, educates and inspires students to reach their full potential.

“Puyallup School District provides equal opportunities in education and employment and does not discriminate on the basis of sex, race, creed, religion, color, national origin, age, honorably discharged veteran or military status, sexual orientation including gender expression or identity, the presence of any sensory, mental, or physical disability, or the use of a trained dog guide or service animal by a person with a disability in its programs and activities and provides equal access to the Boy Scouts and other designated youth groups.
Students and staff are protected against sexual harassment by anyone in any school program or activity, including on the school campus, on the school bus, or off-campus, such as a school-sponsored field trip.
Questions or complaints of alleged discrimination or harassment may be directed to:
ADA/Human Resources Compliance Coordinator: Amie Brandmire ~ (253) 841-8666, brandmah@puyallup.k12.wa.us;
Chief Equity and Achievement Officer: Gerald Denman ~ (253) 840-8966, denmange@puyallup.k12.wa.us;
Title IX Coordinator, Jim Meyerhoff – (253) 841-8785, meyerhja@puyallup.k12.wa.us; or
Section 504 Coordinator, Gerald Denman ~ (253) 840-8966, denmange@puyallup.k12.wa.us.
All individuals may be reached at this address:
Puyallup School District
302 2nd Street SE
Puyallup, WA 98372”